Multiple burdens of malnutrition and relative remoteness in rural Ecuadorian communities.
Public Health Nutr
; 24(14): 4591-4602, 2021 10.
Article
em En
| MEDLINE
| ID: mdl-33155533
OBJECTIVE: Social and economic changes associated with new roads can bring about rapid nutritional transitions. To study this process, we: (1) describe trends in adult overweight and obesity (OW/OB) among rural Afro-Ecuadorians over time and across a gradient of community remoteness from the nearest commercial centre; (2) examine the relationship between male and female adult OW/OB and factors associated with market integration such as changing livelihoods and (3) examine the co-occurrence of adult OW/OB and under-five stunting and anaemia. DESIGN: Adult anthropometry was collected through serial case-control studies repeated over a decade across twenty-eight communities. At the same time, anthropometry and Hb were measured for all children under 5 years of age in every community. SETTING: Northern coastal Ecuador. PARTICIPANTS: Adults (n 1665) and children under 5 years of age (n 2618). RESULTS: From 2003 and 2013, OW/OB increased from 25·1 % to 44·8 % among men and 59·9 % to 70·2 % among women. The inverse relationship between remoteness and OW/OB in men was attenuated when adjusting for urban employment, suggesting that livelihoods mediated the remoteness-OW/OB relationship. No such relationship was observed among women. Communities with a higher prevalence of male OW/OB also had a greater prevalence of stunting, but not anaemia, in children under 5 years of age. CONCLUSIONS: The association between male OW/OB and child stunting at the community level, but not the household level, suggests that changing food environments, rather than household- or individual-level factors, drove these trends. A closer examination of changing socio-economic structures and food environments in communities undergoing rapid development could help mitigate future public health burdens.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Desnutrição
Tipo de estudo:
Observational_studies
/
Prevalence_studies
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Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Child, preschool
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Female
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Humans
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Male
País/Região como assunto:
America do sul
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Ecuador
Idioma:
En
Revista:
Public Health Nutr
Assunto da revista:
CIENCIAS DA NUTRICAO
/
SAUDE PUBLICA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos
País de publicação:
Reino Unido